The client is now in less respiratory distress and is breathing at a rate of 40 breaths/minute. A transesophageal echocardiogram has been prescribed. The nurse recognizes that parents need extra support during invasive procedures.

For each intervention, click to indicate which intervention is suited to develop client trust for an infant or a toddler. Each row must have only one response option selected.

Use firm and direct approach.

Keep parents in line of vision.

Designate one healthcare provider (HCP) to speak during procedure.

Involve parents in procedure if desired.

Place familiar object with client if parents cannot be there.

Prepare parents separately to avoid misinterpretation of words.

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"}}

Use firm and direct approach (Toddler): Toddlers benefit from clear, simple, and direct communication. They are in a stage of autonomy vs. shame/doubt and respond best to firm guidance and structured interactions to feel secure.
Keep parents in line of vision (Infant): Infants rely heavily on visual and sensory contact with caregivers for security. Seeing their parent reduces stress and promotes trust during procedures.
Designate one HCP to speak during procedure (Toddler): Toddlers can become overwhelmed with multiple voices. Having one consistent speaker reduces confusion and helps the child focus, improving cooperation and trust.
Involve parents in procedure if desired (Infant): Infants develop trust through attachment and proximity to caregivers. Parental involvement (holding, soothing) provides comfort and reduces anxiety.
Place familiar object with client if parents cannot be there (Infant): Familiar items (blanket, toy) provide sensory comfort and continuity, helping reduce distress when the primary caregiver is absent.
Prepare parents separately to avoid misinterpretation of words (Toddler): Toddlers think concretely and may misinterpret medical language (e.g., “cut,” “hurt”). Educating parents separately prevents fear and allows them to support the child appropriately.

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Correct Answer is D

Explanation

A. While removing dentures may be necessary for some oral procedures or to prevent choking if they are loose, it does not address the primary concern in this scenario, which is the risk of airway obstruction or respiratory depression caused by morphine in a client with OSA. Removing dentures does not improve oxygenation or ventilation and therefore is not a priority.

B. Raising the head of the bed can help reduce upper airway obstruction by improving the mechanics of breathing in clients with OSA. Elevation may also help with comfort and reduce the risk of aspiration. While this is beneficial, it does not provide the continuous airway support needed for a client who has received an opioid, which depresses respiratory drive and increases the likelihood of airway collapse.

C. Ensuring that side rails are up is a safety measure to prevent falls, particularly in clients who may become drowsy or confused after receiving medications like morphine. Although important for overall safety, this intervention does not address the most immediate risk of airway compromise or hypoventilation, which could be life-threatening.

D. This is the most critical intervention. Clients with OSA are prone to airway collapse during sleep or sedation, and opioids like morphine further depress the central respiratory drive, increasing the risk of apnea and hypoxemia. Using a CPAP or BiPAP device maintains airway patency, improves oxygenation, and reduces the risk of respiratory compromise. Applying the device before leaving the client ensures that ventilation is supported continuously and that the client is protected from potentially life-threatening respiratory events while unattended.

A. Odynophagia B. Epigastric pain C. Dyspepsia D. Emesis

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B,C"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"}}

Explanation

Odynophagia (painful swallowing) – GERD: Odynophagia is more commonly associated with GERD, where stomach acid reflux irritates the esophagus, causing pain with swallowing. Gastritis and PUD primarily affect the stomach lining and may cause epigastric discomfort but usually not pain specifically during swallowing.
Epigastric pain – Gastritis, PUD, GERD: Epigastric pain is a common symptom for all three conditions. Gastritis involves inflammation of the stomach lining; PUD involves a mucosal defect in the stomach or duodenum; GERD can cause burning pain in the upper abdomen due to acid reflux. The timing and triggers (after meals, relief with antacids, or nocturnal pain) may help differentiate them clinically.
Dyspepsia (indigestion, bloating, discomfort) – Gastritis, PUD, GERD: Dyspepsia is a generalized upper abdominal discomfort seen in all three conditions. It may present as bloating, nausea, or a feeling of fullness after meals.
Emesis (vomiting) – Gastritis, PUD: Vomiting can occur in gastritis and PUD due to irritation of the gastric mucosa or obstruction from ulceration. While GERD may occasionally cause regurgitation, true emesis (forceful expulsion of stomach contents) is less typical in GERD.

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Naxlex Comprehensive Predictor Exams

The nurse administers morphine to a client for chest pain who also has obstructive sleep apnea (OSA). Which intervention is most important for the nurse to implement before leaving the client alone?

Correct Answer is D

Explanation

The nurse is reviewing the assessment data. For each assessment finding, click to indicate if it is a symptom of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), or gastritis. Each column must have at least one response option selected.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B,C"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"}}

Explanation

The plan of care for a client who was recently diagnosed with breast cancer includes the nursing problem, "Anxiety related to the threat of death secondary to the cancer diagnosis." Which expected outcome should the nurse identify for this client?

An older client with an acute attack of gouty arthritis receives a prescription for indomethacin 50 mg PO three times a day. The client prefers an oral suspension which is available 5 mg/mL. How many mL should the nurse administer each day? (Enter numerical value only.)

A client's morning assessment includes bounding peripheral pulses, weight gain of 2 pounds (0.91 kg), pitting ankle edema, and moist crackles bilaterally. Which intervention is most important for the nurse to include in this client's plan of care?

A client arrives at the emergency department after blunt chest trauma with severe shortness of breath, distended neck veins, hypotension, and deviation of the trachea to the left. Which statement should the nurse provide about this condition?

The nurse is evaluating the effectiveness of the incentive spirometer implemented in the client's plan of care. Which outcome statement best describes the effectiveness of the incentive spirometer?

Choose the most likely option for the information missing from the statements by selecting from the lists of options provided. The nurse recognizes that the client has dropdowndiabetes insipidus likely due todropdown. One goal of treatment is to prevent dropdownfrom developing.